RESUMEN
To evaluate the association of standardized phase angle (SPA) with nutritional status, functional parameters, and postoperative outcomes in surgical cancer patients. This prospective study includes 59 cancer patients from Pelotas (Brazil) admitted for elective cancer surgery. We obtained the phase angle through Bioelectrical Impedance Analysis (BIA) and standardized it according to the population's reference values. We estimated the muscle mass using BIA for later calculation of the Skeletal Muscle Index (SMI) and performed handgrip strength (HGS) and gait speed (GS) tests. We used the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutritional status. Postoperative complications and duration of hospital stay were evaluated as the outcomes. The prevalence of malnutrition in the sample was 28.8%, according to ASG-PPP. SPA was statistically lower in patients with malnutrition, with lower HGS and reduced GS. For postoperative outcomes, patients with severe complications and those with prolonged hospitalization also had lower SPA values. The greater the number of functional alterations in patients, the lower the SPA value, mainly when associated with reduced muscle mass assessed by BIA, suggesting that muscle mass reduction plays an important role in the association between functional alterations and phase angle in patients with cancer. According to the parameters used in this study, low SPA value was associated with impaired nutritional and functional status and negative outcomes in the analyzed sample.
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Músculo Esquelético , Neoplasias , Estado Nutricional , Complicaciones Posoperatorias , Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Neoplasias/cirugía , Neoplasias/patología , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Anciano , Desnutrición , Fuerza de la Mano/fisiología , Impedancia Eléctrica , Adulto , Brasil/epidemiología , Tiempo de Internación , Evaluación NutricionalAsunto(s)
Encuestas Nutricionales , Sarcopenia , Absorciometría de Fotón , Humanos , Músculo EsqueléticoRESUMEN
BACKGROUND: Low appendicular skeletal muscle mass (ASM) is associated with negative outcomes, but its assessment requires proper limb muscle evaluation. We aimed to verify how anthropometric circumferences are correlated to ASM and to develop new prediction equations based on calf circumference and other anthropometric measures, using dual-energy X-ray absorptiometry (DEXA) as the reference method. METHODS: DEXA and anthropometric information from 15,293 adults surveyed in the 1999-2006 NHANES were evaluated. ASM was defined by the sum of the lean soft tissue from the limbs. Anthropometric data included BMI and calf, arm, thigh, and waist circumferences. Correlations were assessed by Pearson's correlation, and multivariable linear regression produced 4 different ASM prediction equations. The concordance and the overall 95% limits of agreement between measured and estimated ASM were assessed using Lin's coefficient and Bland-Altman's approach. RESULTS: Calf and thigh circumferences were highly correlated with ASM, independent of age and ethnicity. Among the models, the best performance came from the equation constituted solely by calf circumference, sex, race, and age as independent variables, which was able to explain almost 90% of the DEXA-measured ASM variation. The inclusion of different anthropometric parameters in the model increased collinearity without improving estimates. Concordance between the four developed equations and DEXA-measured ASM was high (Lin's concordance coefficient >0.90). CONCLUSION: Despite the good performance of the four developed equations in predicting ASM, the best results came from the equation constituted only by calf circumference, sex, race, and age. This equation allows satisfactory ASM estimation from a single anthropometric measurement.
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Antropometría/métodos , Composición Corporal , Músculo Esquelético/fisiología , Encuestas Nutricionales , Absorciometría de Fotón , Adulto , Anciano , Índice de Masa Corporal , Estudios Transversales , Etnicidad , Femenino , Humanos , Pierna/anatomía & histología , Extremidad Inferior , Masculino , Persona de Mediana Edad , Sarcopenia/diagnóstico , Muslo/anatomía & histologíaRESUMEN
OBJECTIVE: We developed and described a new equation to estimate fat-free mass derived from BIA using a sample population from Brazil and having Dual-energy X-ray absorptiometry (DXA) as the reference method. We also compared this new equation with two published and widely used equations developed in high-income countries. METHODS: Cross-sectional study with 294 healthy adults from Pelotas, Brazil. DXA was used to assess total fat mass and fat-free mass aiming to obtain reference measures for the development of the new BIA equation. Multivariable linear regression models including fractional polynomials were used to find the best predictive model for FFM, using resistance, reactance, age, weight and height as the independent variables. Models were developed separately for men and women. The bootstrapping method was used to test the validity of the new equation. Finally, the Bland-Altman approach was used to assess the agreement of our equations and the two others widely used equations with the FFM measured by DXA. RESULTS: The new equations explained more than 80% of the variation in fat-free mass percentage from DXA. In the bootstrapping analysis, the new equations presented good validity, as the corrected RMSE was similar to those found in regression analysis. Finally, the new equations presented a better concordance when compared to two validated equations from US and Switzerland. CONCLUSION: The new developed equations appear to be the best options to predict fat-free mass percentage in Brazilian adults by bioelectrical impedance and appear to fit well in all Brazilian population due to the good validity presented.
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Composición Corporal/fisiología , Impedancia Eléctrica , Absorciometría de Fotón , Adulto , Anciano , Pesos y Medidas Corporales/métodos , Pesos y Medidas Corporales/normas , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
Introdução: A composição corporal e sua distribuição sofrem mudanças conforme a idade. Por isso, avaliar o uso de indicadores antropométricos para avaliação da adiposidade corporal em idosos é de extrema importância. Método: Trata-se de um estudo transversal, realizado com 108 idosos cadastrados em 11 unidades básicas de saúde do município de Pelotas-RS integrantes da Estratégia Saúde da Família. Para a avaliação nutricional, foram aferidos: altura, peso, circunferência da cintura e circunferência do quadril. O percentual de gordura corporal (%GC) foi verificado por bioimpedância (BIA) e pelo índice de Adiposidade Corporal (IAC) calculado conforme proposto por Bergman et al. Resultados: Os idosos apresentaram médias %GC, verificado pelos dois indicadores BIA e IAC, acima do recomendado (38,5 e 35,6, respectivamente). Conclusão: São necessárias mudanças no estilo de vida destes idosos, incentivando o consumo alimentar saudável e a pratica de atividade física.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Tejido Adiposo , Anciano , Antropometría , Impedancia EléctricaRESUMEN
Objetivos: Avaliar o estado nutricional, a adequação da terapia nutricional enteral, os fatores que interferem na sua administração e a sobrevida de pacientes críticos. Método: Estudo observacional prospectivo, com pacientes internados na Unidade de Terapia Intensiva de um Hospital Universitário. Foram incluídos pacientes com idade superior a 18 anos que receberam nutrição enteral por período superior a 72 horas.O estado nutricional foi avaliado pela Avaliação Subjetiva Global e a terapia nutricional enteral foi considerada adequada quando superior a 70% (valor prescrito/administrado quanto a calorias e proteínas). A sobrevida após seis meses da alta foi analisada pelo teste de Mann Whitney. Resultados: Foram avaliados 32 pacientes, com idade média de 56,4±17,4 anos, sendo 59,4% homens. Na admissão, 75% dos pacientes apresentavam algum grau de desnutrição. A adequação foi de 72,3% para valor calórico e 70,2% para proteínas. A principal causa de interrupção da nutrição enteral foi pausa para procedimentos e exames (81,3%). Pacientes bem nutridos no momento da internação apresentaram sobrevida significativamente maior que pacientes com algum grau de desnutrição após seis meses (p=0,03). Conclusão: A maior parte dos pacientes apresentou desnutrição na admissão e a meta calóricaproteica proposta foi alcançada pela maioria. A sobrevida em seis meses dos pacientes bem nutridos foi significativamente maior do que os demais.(AU)
Objectives: To evaluate the nutritional status, the adequacy of enteral nutritional therapy, the factors that influence enteral nutrition management and the survival analysis of critically ill patients. Methods: A prospective, observational study conducted with patients admitted to the intensive care unit of a university hospital. Patients above 18 years under exclusive enteral nutrition therapy for at least 72 hours were included. Nutritional status was evaluated by the Subjective Global Assessment and enteral nutritional therapy was considered adequate up to 70% of the prescribed (energy and protein). Survival after six months of discharge was analyzed by Mann Whitney test. Results: 32 patients were included; the mean of age was 56.4±17.4 years and 59.4% were man.On admission, 75% of patients had some degree of malnutrition. The adequacy was 72.3% for calories and 70.2% for proteins. The main cause of interruption of enteral nutrition was breaks procedures and tests (81.3%). Well-nourished patients at admission had a significantly longer survival than patients with some degree of malnutrition after six months (p=0.03). Conclusion: Most of the patients presented malnutrition at admission and the proposed caloric-protein target was reached by the majority. The survival rate at six months of well-nourished patients was higher than others.(AU)
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Humanos , Estado Nutricional , Nutrición Enteral/instrumentación , Unidades de Cuidados Intensivos , Análisis de Supervivencia , Estudio Observacional , Necesidades NutricionalesRESUMEN
Introdução: O tipo de atividade física (AF) pode influenciar a relação entre esta e a densidade mineral óssea (DMO). Desta forma, o objetivo do presente estudo é avaliar a relação entre diferentes tipos de AF e DMO em adultos. Método: Estudo transversal realizado com amostra de conveniência (n=208 indivíduos de 20 a 59 anos) de Pelotas, RS. A DMO (g/cm2) foi avaliada por absorciometria de raios-X de dupla energia (DXA) e a prática de caminhada e AF de intensidades moderada e vigorosa no lazer foram avaliadas por meio da respectiva seção da versão longa do Questionário Internacional de Atividade Física (IPAQ). A associação entre a DMO e os diferentes tipos de AF foi avaliada por regressão linear. Resultados: Em torno de 67% dos participantes atendiam à recomendação de ≥150 min/sem de AF. Não houve diferença estatisticamente significativa nas medidas da DMO entre indivíduos com maior ou menor tempo semanal em prática de caminhada, AF de intensidade moderada e vigorosa, isoladamente. Porém, foi observado um aumento, com margem inferior do intervalo de confiança no limite da significância, na DMO de indivíduos do segundo tercil de tempo gasto em AF total 160-300 min/sem (ß=0,025 IC95%=0,001; 0,049), quando comparados ao grupo menos ativo. Conclusão: O estudo não encontrou associação entre DMO e a prática de caminhada e AF de intensidade moderada e vigorosa, podendo haver uma relação com o total acumulado de AF por semana, entre indivíduos que atendem à recomendação de AF, mas não são altamente ativos.(AU)
Introduction: Type of physical activity (PA) can influence the relationship between it and bone mineral density (BMD). Thus, the aim of the current study is evaluate the relationship between different types of PA and BMD in adults. Methods: Cross-sectional study using a convenience sample (n=208 individuals from 20 to 59 years old) in Pelotas, RS. BMD (g/cm2) was measured by dual energy X-ray absorptiometry (DXA) and time spent in walking and moderate and vigorous PA during the leisure-time was evaluated by the International Physical Activity Questionnaire in the long version. Association between BMD and types of PA was evaluated by linear regression analyses. Results: About 67% out of the subjects reached the recommendation of ≥150 min/week of PA during the leisure-time. There was no statistically significant difference in the BMD among individuals with higher or lower weekly time spent in walking, moderate or vigorous PA. However, a slightly difference was observed in BMD from subjects in the second tertile of time spent in any activity 160-300 min/week (ß=0.025 IC95%=0.001; 0.049), in comparison to individuals in the first tertile of PA. Conclusion: There was no statistical association of walking, moderate and vigorous PA alone with BMD. It is possible a relationship between the total amount weekly spent in any PA in individuals who reached the PA recommendation but were not highly active.(AU)
Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Composición Corporal , Densidad Ósea , Actividad Motora , Absorciometría de Fotón/instrumentación , Estudios Transversales/instrumentación , CaminataRESUMEN
Adipose tissue is a vital component of the human body, but in excess, it represents a risk to health. According to the World Health Organization, one of the main factors determining excessive body adiposity is the dietary habit. This systematic review investigated longitudinal studies that assessed the association between diet and body fat in adolescents and young adults. Twenty-one relevant papers published between 2001 and 2015 were selected. The most used method for estimating body fat was the body mass index (15 studies). Diet was most commonly assessed by estimating the consumption of food groups (cereals, milk and dairy products) and specific foods (sugar-sweetened beverages, soft drinks, fast foods, milk, etc.). Ten studies found a direct association between diet and quantity of body fat. During adolescence, adhering to a dietary pattern characterized by high consumption of energy-dense food, fast foods, sugar-sweetened beverages and soft drinks, as well as low fiber intake, appears to contribute to an increase in body fat in early adulthood. The findings of the present study suggest that the frequent consumption of unhealthy foods and food groups (higher energy density and lower nutrient content) in adolescence is associated with higher quantity of body fat in early adulthood.
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Tejido Adiposo/metabolismo , Dieta/normas , Conducta Alimentaria/fisiología , Adolescente , Factores de Edad , Índice de Masa Corporal , Humanos , Adulto JovenRESUMEN
Abstract Adipose tissue is a vital component of the human body, but in excess, it represents a risk to health. According to the World Health Organization, one of the main factors determining excessive body adiposity is the dietary habit. This systematic review investigated longitudinal studies that assessed the association between diet and body fat in adolescents and young adults. Twenty-one relevant papers published between 2001 and 2015 were selected. The most used method for estimating body fat was the body mass index (15 studies). Diet was most commonly assessed by estimating the consumption of food groups (cereals, milk and dairy products) and specific foods (sugar-sweetened beverages, soft drinks, fast foods, milk, etc.). Ten studies found a direct association between diet and quantity of body fat. During adolescence, adhering to a dietary pattern characterized by high consumption of energy-dense food, fast foods, sugar-sweetened beverages and soft drinks, as well as low fiber intake, appears to contribute to an increase in body fat in early adulthood. The findings of the present study suggest that the frequent consumption of unhealthy foods and food groups (higher energy density and lower nutrient content) in adolescence is associated with higher quantity of body fat in early adulthood.
Resumo O tecido adiposo é um componente vital do corpo humano, mas em excesso representa risco à saúde. Conforme a Organização Mundial da Saúde, um dos principais fatores determinantes do excesso de peso é o hábito alimentar. Essa revisão sistemática investigou estudos longitudinais que avaliaram a relação entre dieta e gordura corporal em adolescentes e adultos jovens. Vinte e um artigos publicados de 2001 a 2015 foram selecionados. O método mais utilizado para estimar gordura corporal foi o índice de massa corporal (15 estudos). A dieta foi avaliada principalmente pelo consumo de grupos alimentares (cereais, leite e produtos lácteos) e alimentos específicos (bebidas açucaradas, refrigerantes, “fast foods”, leite e etc.). Dez estudos encontraram uma associação direta entre dieta e quantidade de gordura corporal. Um padrão alimentar com alto consumo energético e de gordura e baixo de fibras e o hábito de consumir “fast foods”, bebidas açucaradas e refrigerantes na adolescência, contribuíram para um aumento da gordura corporal no início da vida adulta. Os achados deste estudo sugerem que o consumo de alimentos específicos e grupos de alimentos não saudáveis (alta densidade energética e baixo conteúdo de nutrientes) na adolescência e início da vida adulta estão associados com maior quantidade de gordura corporal.
Asunto(s)
Humanos , Adolescente , Adulto Joven , Tejido Adiposo/metabolismo , Dieta/normas , Conducta Alimentaria/fisiología , Índice de Masa Corporal , Factores de EdadRESUMEN
PURPOSE: We evaluated phase angle, sarcopenia, and handgrip strength as prognostic factors of postoperative morbimortality in patients with cancer. METHODOLOGY: We conducted a prospective study with 60 oncology patients admitted for elective surgery between November 2015 and May 2016. We calculated the standardized phase angle (SPA) and the skeletal mass index of the subjects based on their bioelectrical impedance tests. Handgrip strength (HGS) was measured using a hydraulic dynamometer. Diagnosis of sarcopenia followed the criteria of the European Working Group on Sarcopenia in Older People. The nutritional status of each subject was evaluated through the Patient-Generated Subjective Global Assessment. Evaluation of postoperative complications followed the Clavien-Dindo classification. We also evaluated the duration of hospital stay. Outcomes were postoperative complications and duration of hospital stay. RESULTS: The prevalence of malnutrition was 28.3%, and the prevalence of sarcopenia was 18.6%. The SPA was significantly lower among those who had severe postoperative complications or long hospital stays, while HGS and sarcopenia showed no relationship with these outcomes. Malnutrition was also related to postoperative outcomes. CONCLUSION: SPA can be considered a prognostic factor in postoperative morbimortality for patients with cancer.
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Neoplasias/cirugía , Estado Nutricional/fisiología , Adolescente , Adulto , Femenino , Fuerza de la Mano , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Neoplasias/mortalidad , Pronóstico , Estudios Prospectivos , Sarcopenia , Adulto JovenRESUMEN
Introdução: O estado nutricional do idoso é afetado por alterações fisiológicas, assim como por sua situação socioeconômica. As alterações mais importantes na composição corporal são o aumento da gordura corporal total e a redução do tecido muscular. Método: Estudo transversal descritivo, realizado com idosos maiores de 60 anos de idade cadastrados nas 11 Unidades Básicas de Saúde do município de Pelotas, RS, que fazem parte da Estratégia Saúde da Família. Foi realizada uma avaliação nutricional, na qual foram coletados dados antropométricos, como peso, altura, circunferência da cintura (CC) e da panturilha (CP), além de ser aplicada a Miniavaliação Nutricional (MAN). Resultados: Foram analisados 119 idosos, com média de idade de 75±6,5 anos e 59% não tinham companheiro. Houve prevalência de sobrepeso com o uso do Índice de Massa Corporal (IMC) (54,6%), obesidade abdominal pela CC (84,0%), eutrofia de acordo com a medida da CP (91,6%) e MAN (63,0%). O sexo feminino apresentou associação positiva com a obesidade abdominal (p<0,01) e com o IMC (p=0,05) quando comparado ao sexo masculino. Conclusão: A maioria dos idosos encontrou-se sem risco nutricional (MAN e CP), porém foram verificadas altas prevalências de obesidade abdominal (CC) e sobrepeso (IMC). O rastreamento do risco nutricional nos idosos é importante, pois mesmo com sobrepeso os idosos podem apresentar risco de desnutrição e utilizando esses métodos foi evidenciada a presença de excesso de peso, excluindo a concomitância com risco nutricional.(AU)
Introduction: The nutritional status of elderly is affected by physiological changes as well as their socioeconomic situation. The most important changes in body composition are the increase in total body fat and the reduction of muscle tissue. Methods: Cross-sectional study realized with elderly people over 60 years old registered at eleven Basic Health Units of the city of Pelotas, RS, which are part of Family Health Strategy. A nutritional assessment was realized, in which anthropometric data were collected as weight, height, waist circumference (WC), calf circumference (CC), besides the application of Mini Nutritional Assessment (MNA). Results: 119 elderly people were analyzed, with the average age of 75±6.5 years and 59% had no life partner. There was a prevalence of overweight through Body Mass Index (BMI) (54.6%), abdominal obesity by WC (84.0%), eutrophic according the measure of CC (91.6%) and MNA (63,0%). Female gender was positively associated with abdominal obesity (p<0.01) and with BMI (p=0.05) when compared to male gender. Conclusion: Most of the elderly are without nutritional risk (MNA and CC), however, high prevalence rates of abdominal obesity (WC) were observed and overweight (BMI). The nutritional risk tracking in the elderly is important, because although being overweight the elderly may present malnutrition risk and using these methods was evidenced the presence of excess weight, excluding concomitance with nutritional risk.(AU)
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Humanos , Anciano , Anciano de 80 o más Años , Centros de Salud , Estado Nutricional , Estrategias de Salud Nacionales , Evaluación Nutricional , Antropometría/instrumentación , Epidemiología Descriptiva , Estudios Transversales/instrumentación , Sobrepeso , ObesidadRESUMEN
PURPOSE: Methodological paper aiming to describe the development of a digital and self-reported food frequency questionnaire (FFQ), created to the 1982 and 1993 Pelotas Birth Cohorts. METHODS: The instrument was created based on FFQs previously applied to subjects belonging to both cohorts in the 2004 and 2008 follow-ups. The FFQ was developed including 88 foods and/or meals where frequencies were clustered from a minimum of never or once/month to a maximum of greater than or equal to 5 times/day. The closed options related to portions were based on a 24-hour recall previously asked to a subsample from the 1993 cohort. Three options for portions were created: equal to, less than or greater than. Equal to portion was described based on the 50 percentile of each food consumed reported in a 24-hour recall. Photographs of portions related to the 50 percentile for each food were also included in the software. RESULTS: This digital FFQ included food and meals based on the needs of current researches. The layout of the software was attractive to the staff members as well as to the cohort members. The responding time was 12 minutes and the software allowed several individuals to use it at the same time. Moreover, this instrument dismissed interviewers and double data entry. CONCLUSION: It is recommended the use of the same strategy in other studies, adapted to different contexts and situations.
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Encuestas sobre Dietas , Ingestión de Alimentos , Conducta Alimentaria , Autoinforme , Programas Informáticos , Adolescente , Brasil , Humanos , Adulto JovenRESUMEN
RESUMO: Objetivo: Artigo metodológico com o objetivo de descrever a construção de um questionário de frequência alimentar (QFA) digital autoaplicado, desenvolvido para as coortes de nascimentos de Pelotas de 1982 e 1993. Métodos: O instrumento foi criado com base em QFAs anteriormente utilizados nas duas coortes em acompanhamentos nos anos de 2004 e 2008. O QFA foi elaborado incluindo 88 alimentos e/ou preparações cujas frequências foram agrupadas em categorias desde o valor mínimo de consumo de nunca ou < 1 vez/mês até o máximo de ≥ 5 vezes/dia. As opções fechadas relativas à porção foram construídas considerando recordatórios de 24 horas (R24Hs) anteriormente aplicados à subamostra da coorte de 1993. Três alternativas de porção foram construídas: igual, menos ou mais. A porção igual foi descrita com base no percentil 50 do consumo de cada alimento, obtido a partir das distribuições das porções constantes nos R24H. Fotos das porções relativas ao percentil 50 de cada alimento foram também incluídas ao formato do programa. Resultados: Esse QFA digital incluiu alimentos e preparações que atendem aos objetivos das pesquisas atuais. A aparência do programa foi atrativa à equipe de trabalho e também aos participantes do estudo. O tempo médio de aplicação de 12 minutos e a facilidade de preenchimento possibilitaram que vários participantes respondessem às questões ao mesmo tempo. Além disso, o instrumento dispensou a necessidade de entrevistador e a dupla entrada de dados em programa específico. Conclusão: Recomenda-se o uso dessa mesma estratégia em outros estudos, adaptando-a aos diferentes contextos e situações.
ABSTRACT: Purpose: Methodological paper aiming to describe the development of a digital and self-reported food frequency questionnaire (FFQ), created to the 1982 and 1993 Pelotas Birth Cohorts. Methods: The instrument was created based on FFQs previously applied to subjects belonging to both cohorts in the 2004 and 2008 follow-ups. The FFQ was developed including 88 foods and/or meals where frequencies were clustered from a minimum of never or once/month to a maximum of greater than or equal to 5 times/day. The closed options related to portions were based on a 24-hour recall previously asked to a subsample from the 1993 cohort. Three options for portions were created: equal to, less than or greater than. Equal to portion was described based on the 50 percentile of each food consumed reported in a 24-hour recall. Photographs of portions related to the 50 percentile for each food were also included in the software. Results: This digital FFQ included food and meals based on the needs of current researches. The layout of the software was attractive to the staff members as well as to the cohort members. The responding time was 12 minutes and the software allowed several individuals to use it at the same time. Moreover, this instrument dismissed interviewers and double data entry. Conclusion: It is recommended the use of the same strategy in other studies, adapted to different contexts and situations.
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Humanos , Adolescente , Adulto , Encuestas sobre Dietas , Ingestión de Alimentos , Conducta Alimentaria , Autoinforme , Programas Informáticos , BrasilRESUMEN
OBJECTIVE: This study aimed to develop and validate equations to estimate body fat based on anthropometric measurements of subcutaneous fat thickness (SFT) and muscle thickness (MT) measured by A-mode ultrasound (BodyMetrix) in Brazilian adults. METHODS: Individuals (n = 206) underwent air-displacement plethysmography for body composition assessment. Arm, thigh, and calf circumferences were also obtained. SFT from triceps, biceps, subscapular, abdominal, thigh, and calf regions and MT from triceps, biceps, thigh, and calf regions were measured by BodyMetrix. Prediction equations were developed by stepwise multiple linear regression using the circumferences, weight, height, SFT, and MT. Lin's concordance correlation coefficient, mean difference, and 95% limits of agreement (95% LOA) were assessed in apparent and internal validity. RESULTS: The prediction equation for whole-body fat for men included thigh circumference, triceps and thigh SFT, biceps MT, weight, and height. The equation for women included age, calf circumference, abdominal and calf SFT, weight, and height. The prediction equation overestimated men's whole-body fat by 0.5 percentual points, in average, and the lower and upper 95% LOA were -6.8% and 7.7%, respectively. For women, the prediction equation overestimated whole-body fat by 0.1 percentual points, in average. Lower and upper 95% LOA were -6.5% and 6.7%, respectively. Optimism-adjusted results using 500 repetitions with same size samples have shown similar results. Body fat extremes did not influence the whole-body fat estimation. CONCLUSIONS: BodyMetrix A-mode ultrasound, in association with selected conventional anthropometric measurements, proved to be a reliable tool for the estimation of body fat percentage.
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Adiposidad , Grasa Subcutánea/diagnóstico por imagen , Ultrasonografía , Adulto , Índice de Masa Corporal , Peso Corporal , Brasil , Femenino , Humanos , Modelos Lineales , Masculino , Músculo Esquelético/diagnóstico por imagen , Pletismografía , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
BACKGROUND & AIMS: Lean mass (LM) is an important parameter in clinical outcomes, which highlights the necessity of reliable tools for its estimation. The adductor pollicis muscle thickness (APMT) is easily accessible and suffers minimal interference from the adjacent subcutaneous fat tissue. OBJECTIVE: To assess the relationship between the APMT and LM in a sample of Southern Brazilian adults. METHODS: Participants were adults from the 1982 Pelotas (Brazil) Birth Cohort. LM was measured by dual energy X-ray absorptiometry (DXA). LM and lean mass index (LMI - LM divided by the square of height - kg/m(2)) were the outcomes. APMT was measured using a skinfold caliper. The mean of three measurements in the non-dominant hand was used in the analyses. APMT was described according to socio-demographic characteristics and nutritional status. The relationship between APMT and both LM and LMI was evaluated by correlation coefficient and linear regression using APMT as a single anthropometric parameter and also in addition to BMI. RESULTS: APMT was assessed in 3485 participants. APMT was higher in males, non-whites, less-schooled and obese individuals. APMT was moderately correlated to LM and LMI (ranged from 0.44 to 0.57). Correlation coefficients were higher for LMI as outcome and in females (LM: 0.51 and LMI: 0.57). APMT explained 19% and 26% of the variance in LM in males and females, respectively, whereas it explained 26% and 33% of the variance in LMI. APMT increased the prediction for LM in 3 and 4 percentage points in males and females, in comparison to explained by BMI. BMI explained 48% and 59% of the variance of LMI in males and females whereas APMT increased it to 51% and 62% for both sexes, respectively. CONCLUSIONS: Results were not good enough to promote the APMT as a single predictor of LM or LMI in epidemiological studies. APMT has a little predictive capacity in estimating LM or LMI when BMI is also considered.
Asunto(s)
Composición Corporal , Mano , Músculo Esquelético/fisiología , Grosor de los Pliegues Cutáneos , Absorciometría de Fotón , Índice de Masa Corporal , Brasil , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estado Nutricional , Factores Socioeconómicos , Adulto JovenRESUMEN
BACKGROUND & AIMS: Body composition is important to identify malnutrition, and several anthropometric measurements are used to estimate muscle mass in the clinical practice. This study aimed to assess the adductor pollicis muscle thickness (APMT), its covariates and association with malnutrition in hospitalized surgical patients. METHODS: APMT was measured in 361 surgical patients in both dominant (DAPMT) and non-dominant (NDAPMT) sides. APMT values below the 5th percentile of reference values provided by a healthy population were considered as malnourished. Nutritional status was assessed by Subjective Global Assessment (SGA). The difference in APMT values among nutritional status categories was evaluated, and the association between malnutrition by SGA and APMT was estimated using multivariate linear regression. Sensitivity, specificity and positive and negative predictive values were also calculated. RESULTS: Most patients were women (60.4%). APMT values were significantly different among SGA categories. Well-nourished patients had APMT values significantly higher compared to the ones with moderate or severe malnutrition by SGA, with no significant difference between APMT values in moderate or severe malnourished patients. Statistically significant associations between both DAPMT and NDAPMT below the 5th percentile and malnutrition and were found (RR = 3.99, CI 95% = 3.19-5.00; p < 0.001; and RR = 3.92; CI 95% = 3.10-4.96; p < 0.001; respectively). Gender, age, estimated weight and nutritional status were considered associated factors for APMT. APMT showed low sensitivity (DAPMT: 34.9%, NDAPMT: 37.7%) but high specificity (DAPMT: 98.7%, NDAPMT: 97.8%) to identify malnutrition. CONCLUSIONS: APMT was significantly associated with nutritional status in a sample of surgical patients. The APMT seems to be a simple and useful anthropometric tool to confirm the diagnosis of malnutrition.
Asunto(s)
Músculo Esquelético/metabolismo , Evaluación Nutricional , Estado Nutricional , Procedimientos Quirúrgicos Operativos/efectos adversos , Adolescente , Adulto , Composición Corporal , Índice de Masa Corporal , Brasil , Femenino , Mano , Hospitalización , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Desnutrición Proteico-Calórica/etiología , Desnutrición Proteico-Calórica/fisiopatología , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Factores Socioeconómicos , Adulto JovenRESUMEN
The present study aims to evaluate compliance of cancer patients to EPA-enriched supplementation at the beginning of chemotherapy, and its effects on inflammation. Gastrointestinal and lung cancer patients were randomly assigned to receive nutritional supplement enriched with 2.2 g EPA or standard isocaloric one. Supplements were introduced 72 h before the first chemotherapy and continued for 4 wk. Serum C-reactive protein was measured and its variation was analyzed according to tumor location and treatment group. Compliance was assessed by phone contact and counting of supplement bottles returned after treatment. Sixty-nine patients were assessed, mean aged 65.5 yr old, most of them (59%) men. Gastrointestinal cancer was more prevalent and lung cancer had the highest C-reactive protein values (P = 0.009). Twenty-four patients interrupted treatment (trend for more interruption in EPA group), mainly because of gastrointestinal intolerance. No difference was found in C-reactive protein variation between EPA and control groups after treatment. Lung tumors showed higher inflammation than gastrointestinal ones. A short intervention with EPA was insufficient to reduce inflammation, which may be caused by the frequent abandoning of treatment. The beginning of chemotherapy may not be the optimal time point to initiate EPA supplementation because uncomfortable effects of both treatments may lead to poor adherence.
Asunto(s)
Suplementos Dietéticos , Ácidos Grasos Omega-3/administración & dosificación , Neoplasias Gastrointestinales/terapia , Neoplasias Pulmonares/terapia , Cooperación del Paciente , Anciano , Proteína C-Reactiva/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Método Simple CiegoRESUMEN
Early childhood nutritional factors can play a crucial role in the development of body composition in later phases of life. A systematic literature review was conducted to identify studies on the association between early nutritional determinants and fat-free mass in adulthood. The PubMed and Virtual Health Library electronic databases were used. Nine articles were included after a peer review of the 576 references initially found, published from 2003 to 2009, with healthy subjects and longitudinal analysis. Birth weight and birth length and variations across childhood were strong predictors of fat-free mass at later ages. The studies showed that higher birth weight and greater weight gain in early childhood were associated with greater fat-free mass in adulthood. However, the available data are limited and inconclusive in relation to eating in early childhood as a predictor of fat-free mass at later ages.
Asunto(s)
Distribución de la Grasa Corporal , Adulto , Peso al Nacer , Imagen Corporal , Índice de Masa Corporal , Peso Corporal , Lactancia Materna , Preescolar , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Adulto JovenRESUMEN
Early childhood nutritional factors can play a crucial role in the development of body composition in later phases of life. A systematic literature review was conducted to identify studies on the association between early nutritional determinants and fat-free mass in adulthood. The PubMed and Virtual Health Library electronic databases were used. Nine articles were included after a peer review of the 576 references initially found, published from 2003 to 2009, with healthy subjects and longitudinal analysis. Birth weight and birth length and variations across childhood were strong predictors of fat-free mass at later ages. The studies showed that higher birth weight and greater weight gain in early childhood were associated with greater fat-free mass in adulthood. However, the available data are limited and inconclusive in relation to eating in early childhood as a predictor of fat-free mass at later ages.
Aspectos nutricionais relativos aos primeiros anos de vida podem desempenhar um papel fundamental sobre o desenvolvimento da composição corporal em outras fases da vida. Foi realizada uma revisão sistemática da literatura, identificando estudos que avaliaram a associação entre determinantes nutricionais precoces e a massa livre de gordura no início da vida adulta. Foram utilizadas as bases de dados eletrônicas PubMed e Biblioteca Virtual em Saúde. Nove estudos foram incluídos, após revisão por pares das 576 referências encontradas, publicados entre os anos de 2003 e 2009, conduzidos com indivíduos saudáveis e com análise longitudinal. As variáveis peso e altura ao nascer, assim como suas variações ao longo da infância, são fortes preditores da massa livre de gordura em idades posteriores. Os estudos mostram que quanto maior o peso ao nascer e o ganho de peso nos primeiros anos de vida, maior será a massa livre de gordura na vida adulta. Porém, os dados disponíveis são poucos e inconclusivos com relação à alimentação nos primeiros anos de vida como preditor da massa livre de gordura em idades posteriores.
Aspectos nutricionales en relación con los primeros años de vida pueden desempeñar un papel fundamental sobre el desarrollo de la composición corporal en otras fases de la vida. Se realizó una revisión sistemática de la literatura, identificando estudios que evaluaron la asociación entre determinantes nutricionales precoces y la masa libre de grasa en el inicio de la vida adulta. Se utilizaron las bases de datos electrónicas PubMed y Biblioteca Virtual en Salud. Se incluyeron nueve estudios, tras la revisión por pares de las 576 referencias encontradas, publicados entre los años 2003 a 2009, llevados a cabo con individuos saludables y con un análisis longitudinal. Las variables peso y altura al nacer, así como sus variaciones a lo largo de la infancia, son fuertes predictores de la masa libre de grasa en edades posteriores. Los estudios muestran que cuanto mayor es el peso al nacer y se gana peso durante los primeros años de vida, mayor será la masa libre de grasa en la vida adulta. Sin embargo, los datos disponibles son pocos e inconclusos en relación con la alimentación en los primeros años de vida como predictor de la masa libre de grasa en edades posteriores.
Asunto(s)
Adulto , Preescolar , Humanos , Lactante , Recién Nacido , Adulto Joven , Distribución de la Grasa Corporal , Peso al Nacer , Imagen Corporal , Índice de Masa Corporal , Peso Corporal , Lactancia Materna , Estudios LongitudinalesRESUMEN
OBJETIVO: Descrever a frequência de consumo de diferentes tipos de carnes conforme variáveis sociodemográficas e nutricionais, e analisar o consumo, em adolescentes do Sul do Brasil, de dieta rica em gordura conforme os tipos de carne consumidos. MÉTODOS: Estudo transversal realizado com adolescentes pertencentes à coorte de nascimentos de 1993, em Pelotas (RS). A frequência de consumo de carnes vermelhas, brancas, vísceras e embutidos foi avaliada por um Questionário de Frequência de Consumo Alimentar, adaptado para este estudo. A ingestão de dieta rica em gordura foi avaliada a partir do instrumento proposto por Block. As variáveis independentes foram sexo, cor da pele, nível socioeconômico, escolaridade materna e estado nutricional. Nas análises estatísticas, foram utilizados testes Qui-quadrado de heterogeneidade e de tendência linear. RESULTADOS: Foram avaliados 4.325 adolescentes com idade média de 14,7, DP=0,3 anos, dos quais 51,2% eram do sexo feminino. A frequência de consumo diário de carnes vermelhas foi maior do que a de carnes brancas (43,0% e 9,7%, respectivamente). O consumo de embutidos por mais do que quatro vezes por semana foi referido por 48,5% dos indivíduos, e 81,4% relataram consumir vísceras raramente ou nunca. Adolescentes de maior nível socioeconômico e filhos de mães com maior escolaridade apresentaram maior consumo de carnes vermelhas e embutidos, enquanto aqueles em situação oposta apresentaram maior consumo de carnes brancas. Adolescentes que consomem carnes com maior frequência também consomem dieta rica em gordura. CONCLUSÃO: As carnes consumidas com maior frequência pelos adolescentes foram as vermelhas e os embutidos. No entanto, adolescentes de maior nível socioeconômico consomem carnes vermelhas com maior frequência, enquanto adolescentes menos favorecidos economicamente consomem mais carnes brancas.
OBJECTIVE: The present study investigated the consumption frequency of various meats according to sociodemographic and nutritional variables and analyzed the consumption of high-fat diets according to type of meat by southern Brazilian adolescents. METHODS: This cross-sectional study included the 1993 birth cohort from Pelotas (RS). The consumption frequency of red, white and organ meats and sausage were investigated by a food frequency questionnaire adapted for this study. Dietary fat content was determined as proposed by Block. The independent variables were gender, skin color, socioeconomic level, maternal education level and nutritional status. The statistical analyses included the Chi-square linear tendency test and the Chi-square test of homogeneity. RESULTS: A total of 4,325 adolescents with a mean age of 14.7 years, SD=0.3 years, were assessed, of which 51.2% were females. Red meat was consumed more frequently daily than white meat (43.0% and 9.7%, respectively). Sausage consumption frequency greater than 4 times per week was reported by 48.5% of the sample, and 81.4% reported to consume organ meats rarely or never. Adolescents of higher socioeconomic levels and of mothers with higher education levels consumed more red meats and sausages, while those in the opposite situation consumed more white meats. Adolescents who consumed meats more frequently also consumed a high-fat diet. CONCLUSION: Red meats and sausages were the meats most frequently consumed by the study adolescents. However, adolescents of higher socioeconomic levels consumed red meats more often, while those of lower socioeconomic levels consumed white meats more often.